Adding Insult to Injury / Most pro football players face a future of disability and pain

David Steele, Chronicle Staff Writer

Published 4:00 am, Sunday, September 1, 2002

Curt Marsh celebrated his 43rd birthday a week ago at his suburban Seattle home with his wife of 21 years, their three children, his artificial right leg, several pain-killing prescriptions and an aluminum walker.

Marsh doesn't hesitate to give credit for his lot in life -- the good and the bad -- to one source: football, particularly his seven years playing in the National Football League for the Raiders in Oakland and Los Angeles.

He says he doesn't regret having sacrificed his health for football, for the game he loves -- but also the game that caused his degenerative arthritis, the replacement of one hip and the scheduled replacement of another -- and, seven years after his retirement in 1987, the amputation of his leg from the ankle down.

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Nevertheless, 21 years after eagerly entering the NFL as a first-round draft pick, Marsh has had to come to terms with a grim future -- years, probably decades, of pain and disability. Two days before his birthday, he came home from a nine-week hospital stay after two back surgeries related to degenerative arthritis. Those operations boosted the total to about 30. "I stopped counting at around 21," he says.

As the 83rd NFL regular season gets under way Thursday night when the 49ers play the Giants, Marsh knows he is both typical and atypical of professional football veterans.

Atypical in the severity of his post-career injuries, but typical in the daily presence of pain from the aftereffects of football. Based on studies over the past 15 years and on the testimonials of former players, escaping unscathed is virtually impossible. Nearly two-thirds suffer an injury serious enough to require surgery or sideline them eight games or more.

In addition, six of every 10 players suffer a concussion; more than a quarter will suffer more than one, and the odds are that any player who suffers a concussion will later experience headaches and memory problems. Nearly half of all players retire from football because of an injury.

Applying those figures to Thursday night's game in East Rutherford, N.J., some 70 of the 106 players in uniform for both teams will someday suffer a football injury causing long-term pain that might never go away. It's a type of pain that Marsh says makes him feel as old as pro football itself.

"Physically, I feel 83," he says.

David Meggyesy, a former NFL linebacker, author, lecturer and now director of the NFL Players Association's San Francisco office, likened the issue of post-NFL injuries to "the elephant in the room that no one wants to say is in the room."

Trace Armstrong knows it's there. The Raiders' defensive tackle, entering his 14th NFL season and a month away from his 37th birthday, has undergone 16 surgeries. He is coming back from a torn right Achilles tendon that erased the final 14 games of last season. Post-NFL life, he says, "crosses your mind all the time. I'm fully aware that my body has paid a price for what I do for a living. Every time I've had something (injured) or had something done, I've always made sure I'm fully aware of what the risks are, and what I can do to manage the risks."

As is the case in all walks of life, few young players believe it will happen to them. "It was like you dressed in a phone booth on the way to the stadium," Marsh ays of his own youth. But the evidence is all around.

"You go to our retired players' conventions," says Armstrong, who is president of the players' association, "and some of these guys don't look so good. Young men, onetime great athletes, but they don't move around so well."

Most pro football players don't die young and leave a handsome corpse. The widely circulated myth that football players die early was largely disproved by a 1994 study by the National Institute for Occupational Safety and Health. The flip side, however, is that many players are in for decades of misery they never envisioned.

Horror stories abound in every generation of players. For Armstrong, it's Dan Hampton, his teammate with the Bears for his first two seasons. When Hampton limped to the podium for his acceptance speech at the Pro Football Hall of Fame in July, among the people he thanked was the team trainer, who helped him play despite 12 knee operations in his 12-year career.

Hampton has a long way to go to catch Hall of Famer Jim Otto, who started 210 consecutive games at center for the Raiders in the 1960s and '70s. Otto has had 40 operations, mostly to his knees. He revealed recently that he is battling prostate cancer.

Two Denver Broncos players from the Super Bowl team of just four years ago seem destined for similar fates. Lineman Mark Schlereth retired a year ago after 12 pro seasons and 29 operations, 15 on his left knee alone, and running back Terrell Davis quit two weeks ago at age 29 because of arthritis in both knees, one of which was severely injured three years ago.

"Everybody walks away with an injury," says Meggyesy, who considers himself relatively healthy 30 years after his career ended. "You just don't see that being done to the human body and not think there are going to be consequences later in life."

A survey done by Ball State University in 1994 showed that 65 percent of players who retired before the 1990s had suffered an injury serious enough to require surgery or cost them at least eight games. Those players averaged more than one surgery each in their careers. The problem has grown in recent years. Players in the 1980s suffered serious injuries and underwent operations at twice the rate of those who played in the 1950s or earlier, the survey found.

An updated study on injuries is under way at the University of North Carolina, covering players who finished their careers in the 1990s. That study is expected to reflect the effects of the increased size and speed of players, and of improved medical care, as well as the influence of painkilling medication, steroids and other substances, plus long-term exposure to artificial turf.

Up-to-date figures on head injuries are available from a 2000 abstract presented to the American Academy of Neurology by Barry Jordan of the Brain Injury Program of Burke Rehabilitation Hospital in White Plains, N.Y. Sixty percent of former NFL players surveyed had suffered at least one concussion, and 26 percent had suffered two or more. The abstract concluded that those players "reported more cognitive complaints and symptoms consistent with a persistent postconcussion syndrome" than those who hadn't suffered a concussion.

In all, said the Ball State survey, 46 percent of players retired from football as a direct result of injuries. Most were not of the spectacular variety that live on in the minds of fans and on film and video -- Joe Theismann's broken leg in 1985, the hit that paralyzed Darryl Stingley in 1978 or Steve Young's final concussion in 1999. The most damage occurred during routine plays that fans, watching on TV or in the stands, often miss because they have no sense of the sheer force of the collisions on the field. That's been compared to a car crash at 25 mph, or to running the length of a driveway and slamming into the garage door -- in both cases, repeatedly.

"Think about it," Marsh said. "Our intent is to run into each other as hard as we can, 60 or 70 times a game, over and over again, trying to knock the other person down or move them out of the way. If someone asked you to do that for a living, you'd think they're crazy."

And that doesn't include practices, training camps, exhibition games or the year-round weightlifting that contribute to the problems later in life.

Recognition of, and attention to, the long-term effects of this have grown in the past decade, aided largely by the fact that the union and league have had labor peace since 1993. Besides fighting to remove artificial turf -- 11 fewer teams play on it now than did 10 years ago -- and steering players toward increased medical assistance, the union has pushed for improved protection and care for active players, as well as better benefits for retired players. (Marsh receives a degenerative-injury benefit, a recent addition to the plan, but was turned down twice before being approved in 1998.)

"The public has no idea about these kind of things -- they think these guys are rich and famous and living the life of luxury," said Dee Becker, the assistant director for the union's 3,500-member Retired Players Association. "They think (the players) don't have another worry for the rest of their lives,

Marsh can relate. He has had to deal with the fact that he will always struggle to keep a job (he had to give up one with the city of Everett, Wash., because he was spending so much time in the hospital), couldn't play with his children as much as he wanted when they were younger and has to reapply for his NFL disability benefits every year. Making motivational speeches, writing a book ("Dare to Dream," in 2000), entering weightlifting competitions for amputees and advising pro athletes in all sports about the physical risks and tolls of playing have helped him cope.

Marsh long ago absolved the Raiders and the NFL of blame, even though a misdiagnosis of a broken ankle by a team doctor, who has since died, led to the amputation. No one, he decided, is responsible for what has happened to him more than he is.

"You've got to remember," Marsh said, "you're a participant in this. They didn't make you take a shot, I took those shots. I'm the one who chose to do this. I chose to do it this way."

Playing hurt

65 percent of former players reported they had suffered at least one injury serious enough to require surgery or cause them to miss at least eight games. .